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“Disadvantaged patient populations”: A theory-informed education needs assessment in an urban teaching hospital

BACKGROUND: Recent calls in medical education and health care emphasize equitable care for disadvantaged patient populations (DPP), with education highlighted as a key mechanism toward this goal. As a first step in understanding potential education needs we wanted to better understand the DPP concep...

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Detalles Bibliográficos
Autores principales: Baker, Lindsay, Kangasjarv, Emilia, McNeil, Beck, Houston, Patricia, Mooney, Stephanie, Ng, Stella
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Canadian Medical Education Journal 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6892306/
https://www.ncbi.nlm.nih.gov/pubmed/31807224
Descripción
Sumario:BACKGROUND: Recent calls in medical education and health care emphasize equitable care for disadvantaged patient populations (DPP), with education highlighted as a key mechanism toward this goal. As a first step in understanding potential education needs we wanted to better understand the DPP concept. METHODS: Framed as a critical needs assessment, we used a critical discourse analysis approach to explore the meanings and effects of DPP. We analyzed transcripts from 15 focus groups with trainees, staff and patients. RESULTS: We identified three main assumptions about DPP: 1) disadvantaged patients require care above what is normal; 2) the system is to blame for failures in serving disadvantaged patients; and 3) labeling patients is problematic and stigmatizing. Patients appreciated that the DPP concept opened up better access to care, but also felt ‘othered’ by the concept. As a result, patients felt they were not accessing the same level of care in terms of compassion and respect. CONCLUSION: We must define access beyond ability to receive services; access must also engender a sense of common humanity and respect. With this aim, we suggest three, theory-informed educational approaches to help improve care for DPP: 1) sharing authentic and varied stories; 2) fostering dialogue; 3) aligning assessment and educational approaches.